Safety and feasibility of arterial wall targeting with robot-assisted high intensity focused ultrasound: a preclinical study

High-intensity focused ultrasound (HIFU) is a potential noninvasive thermal ablation method for the treatment of peripheral artery disease. Dual-mode ultrasound arrays (DMUA) offer the possibility of simultaneous imaging and treatment. In this study, safety and feasibility of femoral artery robot-as...

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Published in:International journal of hyperthermia Vol. 37; no. 1; pp. 903 - 912
Main Authors: Groen, M. H. A, Slieker, F. J. B, Vink, A., de Borst, G. J., Simons, M. V., Ebbini, E. S., Doevendans, P. A., Hazenberg, C. E. V. B., van Es, R.
Format: Journal Article
Language:English
Published: Taylor & Francis 01.01.2020
Taylor & Francis Group
Subjects:
animal-study
arterial vessel wall
High-intensity focused ultrasound
noninvasive therapy
peripheral artery disease
safety
ISSN:0265-6736, 1464-5157, 1464-5157
Online Access:Get full text
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Summary:High-intensity focused ultrasound (HIFU) is a potential noninvasive thermal ablation method for the treatment of peripheral artery disease. Dual-mode ultrasound arrays (DMUA) offer the possibility of simultaneous imaging and treatment. In this study, safety and feasibility of femoral artery robot-assisted HIFU/DMUA therapy was assessed. In 18 pigs (∼50kg), angiography and diagnostic ultrasound were used to visualize diameter and blood flow of the external femoral arteries (EFA). HIFU/DMUA-therapy was unilaterally applied to the EFA dorsal wall using a 3.5 MHz, 64-element transducer, closed-loop-control was used to automatically adjust energy delivery to control thermal lesion formation. A continuous lesion of at least 25 mm was created by delivering 6-8 HIFU shots per imaging plane perpendicular to the artery spaced 1 mm apart. Directly after HIFU/DMUA-therapy and after 0, 3 or 14 days follow up, diameter and blood flow were measured and the skin was macroscopically examined for thermal damage. The tissue was removed for histological analysis. No complications were observed. The most frequently observed treatment effect was formation of scar tissue, predominantly in the adventitia and the surrounding tissue. No damage to the endothelium or excessive damage of the surrounding tissue was observed. There was no significant decrease in the mean arterial diameter after HIFU/DMUA-therapy. HIFU/DMUA therapy successfully targeted the vessel walls of healthy porcine arteries, without causing endothelial damage or other vascular complications. Therefore, this therapy can be safely applied to healthy arterial walls in animals. Future studies should focus on safety and dose-finding in atherosclerotic diseased arteries.
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ISSN:0265-6736
1464-5157
1464-5157
DOI:10.1080/02656736.2020.1795278